Individual
CARRIE J. PETKAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.P.C.
Contact information
Practice address
5111 CRANE RD, EDINBORO, PA 16412-1683
(814) 882-3449
Mailing address
5111 CRANE RD, EDINBORO, PA 16412-1683
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC006653
PA
Other
Enumeration date
12/10/2012
Last updated
12/10/2012
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